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Why is a paediatric respiratory specialist integral to the paediatric rheumatology clinic?

Manisha Ramphul, Kathy Gallagher, Kishore Warrier, Sumit Jagani, Jayesh Mahendra Bhatt
Breathe 2020 16: 200212; DOI: 10.1183/20734735.0212-2020
Manisha Ramphul
1Dept of Paediatric Respiratory Medicine, Nottingham Children's Hospital, Nottingham University Hospitals, Nottingham, UK
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Kathy Gallagher
1Dept of Paediatric Respiratory Medicine, Nottingham Children's Hospital, Nottingham University Hospitals, Nottingham, UK
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Kishore Warrier
1Dept of Paediatric Respiratory Medicine, Nottingham Children's Hospital, Nottingham University Hospitals, Nottingham, UK
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Sumit Jagani
2Dept of Radiology, Nottingham University Hospitals, Nottingham, UK
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Jayesh Mahendra Bhatt
1Dept of Paediatric Respiratory Medicine, Nottingham Children's Hospital, Nottingham University Hospitals, Nottingham, UK
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  • For correspondence: jayesh.bhatt@nuh.nhs.uk
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Abstract

Systemic connective tissue diseases (CTDs) are characterised by the presence of autoantibodies and multiorgan involvement. Although CTDs are rare in children, they are associated with pulmonary complications, which have a high morbidity and mortality rate. The exact pathophysiology remains unclear. The pleuropulmonary complications in CTD are diverse in their manifestations and are often complex to diagnose and manage.

The most common CTDs are discussed. These include juvenile systemic lupus erythematosus, juvenile dermatomyositis, juvenile systemic sclerosis, Sjögren's syndrome and mixed connective tissue disease. We describe the clinical features of the pleuropulmonary complications, focusing on their screening, diagnosis and monitoring. Treatment strategies are also discussed, highlighting the factors and interventions that influence the outcome of lung disease in CTD and pulmonary complications of treatment.

Early detection and prompt treatment in a multidisciplinary team setting, including respiratory and rheumatology paediatricians and radiologists, is paramount in achieving the best possible outcomes for these patients.

Abstract

Pleuropulmonary complications of CTD, though rare in paediatrics, can be associated with high morbidity and mortality. Joint management by respiratory and rheumatology paediatricians is recommended. Treatment includes steroids and other immunomodulators. https://bit.ly/2MCvEpp

Footnotes

  • Conflict of interest: None declared.

  • Received August 11, 2020.
  • Accepted September 1, 2020.
  • Copyright ©ERS 2020
http://creativecommons.org/licenses/by-nc/4.0/

Breathe articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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Vol 16 Issue 4 Table of Contents
Breathe: 16 (4)
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Why is a paediatric respiratory specialist integral to the paediatric rheumatology clinic?
Manisha Ramphul, Kathy Gallagher, Kishore Warrier, Sumit Jagani, Jayesh Mahendra Bhatt
Breathe Dec 2020, 16 (4) 200212; DOI: 10.1183/20734735.0212-2020

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Why is a paediatric respiratory specialist integral to the paediatric rheumatology clinic?
Manisha Ramphul, Kathy Gallagher, Kishore Warrier, Sumit Jagani, Jayesh Mahendra Bhatt
Breathe Dec 2020, 16 (4) 200212; DOI: 10.1183/20734735.0212-2020
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  • Article
    • Abstract
    • Abstract
    • Educational aims
    • Incidence of pleuropulmonary complications in CTD
    • Pathophysiology
    • Juvenile systemic lupus erythematosus
    • Juvenile dermatomyositis
    • Juvenile systemic sclerosis
    • Mixed connective tissue disease
    • Sjögren's syndrome
    • Investigations
    • Treatment
    • Iatrogenic complications of CTD treatment
    • Conclusion
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  • Paediatric pulmonology
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  • Pulmonary manifestations of systemic vasculitis in childhood
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